Provider Demographics
NPI:1518934363
Name:BATEMAN, JAMES W (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:BATEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:122 GRANT STREET
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2281
Mailing Address - Country:US
Mailing Address - Phone:269-687-0808
Mailing Address - Fax:269-687-0811
Practice Address - Street 1:60 NORTH ST. JOSEPH AVE.
Practice Address - Street 2:STE. B
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2282
Practice Address - Country:US
Practice Address - Phone:269-687-0806
Practice Address - Fax:269-687-0811
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301035099207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM41340Medicare ID - Type Unspecified
MIB43912Medicare UPIN